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Anniston Gastroenterology Associates, P.C.

Details

Name: Anniston Gastroenterology Associates, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 07 Nov 2001 (23 years ago)
Entity Number: 000-219-627
Register Number: 000219627
County: Calhoun
Place of Formation: Calhoun County
Principal Address: ANNISTON, AL
Registered Office Street Address: 1730 LEIGHTON AVEANNISTON, AL 36201
Registered Office Street Address ZIP Code: 36201
Authorized Capital: $1,000
Paid Share Capital: $1,000

Activities PRACTICE MEDICINE

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
VQUNLNG7DGH3 2021-11-04 1720 LEIGHTON AVE, ANNISTON, AL, 36207, 3811, USA 1720 LEIGHTON AVE, ANNISTON, AL, 36207, USA

Business Information

Doing Business As (AFF: ANNISTON HMA)
Congressional District 03
State/Country of Incorporation AL, USA
Activation Date 2020-06-01
Initial Registration Date 2020-04-16
Entity Start Date 2002-01-01
Fiscal Year End Close Date Dec 31

Points of Contacts

Electronic Business
Title PRIMARY POC
Name PANKAJ KASHYAP
Address 1720 LEIGHTON AVE, ANNISTON, AL, 36207, USA
Government Business
Title PRIMARY POC
Name PANKAJ KASHYAP
Address 1720 LEIGHTON AVE, ANNISTON, AL, 36207, USA
Past Performance Information not Available

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1083764526 2007-01-10 2009-04-21 PO BOX 126, ANNISTON, AL, 362020126, US 1720 LEIGHTON AVE, ANNISTON, AL, 362073811, US

Contacts

Phone +1 256-237-3284
Fax 2562374104

Authorized person

Name HOLLY BENEFIELD
Role OFFICE MANAGER
Phone 2562373284

Taxonomy

Taxonomy Code 174400000X - Specialist
License Number 19468
State AL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 529909260
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ANNISTON GASTROENTEROLOGY ASSOCIATES 401(K) PLAN 2009 631286628 2010-09-14 ANNISTON GASTROENTEROLOGY ASSOCIATES 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2562373284
Plan sponsor’s address 1720 LEIGHTON AVENUE, ANNISTON, AL, 36207

Plan administrator’s name and address

Administrator’s EIN 631286628
Plan administrator’s name ANNISTON GASTROENTEROLOGY ASSOCIATES
Plan administrator’s address 1720 LEIGHTON AVENUE, ANNISTON, AL, 36207
Administrator’s telephone number 2562373284

Signature of

Role Plan administrator
Date 2010-09-14
Name of individual signing PANKAJ K. KASHYAP, M.D.
Role Employer/plan sponsor
Date 2010-09-14
Name of individual signing PANKAJ K. KASHYAP, M.D.

Agent

Name Role
KASHYAP, PANKAJ Agent

Incorporator

Name Role Address
KASHYAP, PANKAJ Incorporator No data
PATEL, HARSHAD Incorporator 15 JAY CTBOHEMIA, NY 11716
HOPKINS, VIRGINIA Incorporator No data

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State